To the Editor

Gokalp et al. [1] have done an excellent study on the treatment of chronic osteomyelitis by gutter procedure and muscle flap transposition operation, which may be a successful mode of therapy when performed correctly and supported by long-term antibio-therapy. However, we find an obvious mistake in Gokalp MA’s study. The author said that “Written informed consents were obtained from the participants”; however, there is a 2-year-old child in this study, how should he can finished his written informed consents? Therefore, we advise this sentence was revised to “Written informed consents were obtained from the participants and their guardians.”

Through our limited experience, the chronic osteomyelitis of children <3 years was very difficult to deal with, which is especially hard to choose appropriate antibiotic. However, the author even used washing drainage daily with 1,000 ml physiological saline including 80 mg gentamicin for 2 days. As we know, the gentamicin has highly ototoxicity and nephrotoxicity, which is prohibited for young children. So we wonder how it can be used in this study. And we do not know which long bone of this child suffering chronic osteomyelitis, but we know even the femoral shaft of a only 2-year-old children is very small, with a diameter of approximately 1.5 cm. But the width of the area was determined to be smaller than 1/6 of the bony circumference in order not to form a fracture in this article, which is approximately 3 mm. So we want to know how the holes were punched on this marked area at 5-mm intervals using a drill in order to form a 3-mm gutter? It is so difficult a thing that we have not finished it till now in a 2-year-old child.